Let the hosting of the postings begin — so many posts, so little time! I’d like to group these into a few broad categories — Trying to be a "Good" Doctor, Medical Business & Monkey Business, Being a Patient, and Extras….

Reading the latest Annals of Emergency Medicine today, I came across this Policy Statement:

ACEP deplores the threat to public safety that results from the widespread availability of assault weapons and high capacity ammunition devices. ACEP supports a comprehensive ban on all sales of assault weapons and high capacity magazines.

Where to start. I deplore specialty societies that are ignorant of the constitution, and which haven’t learned from recent history. We had an AW ban, and it was a farce. Scawwy-looking guns were banned, while the same guns with different stocks were OK. Also, nobody is crowing about the big changes in gun violence that resulted from its enactment (none attributable to the ban), or pointing out there’s been no change since its repeal.

ACEP should be ashamed of itself for this piece of liberal-pandering. This is the kind of crap that drove me out of the AMA, and is an excellent way to drive EM docs out of ACEP.

Topol concluded, "in my view, nesiritide has not yet met the minimal criteria for safety and efficacy." So, "we need a tune-up of our procedures to eliminate indiscriminate use of drugs, such as nesiritide, when there is not proper evidence of their safety."

I wonder what he has in mind for that procedure? I thought that was the FDA’s role.

But, that makes it easy. Just Say No, at least for now. (And, this again verifies the truism for new drug use: Never be the first to try it, never be the last to adopt it). I wrote about this earlier, and, to my knowledge, none of my colleagues are using it now either.

Today Secretary Michael Chertoff announced the appointment of Jeffrey W. Runge, M.D. as the Department?s new Chief Medical Officer. Dr. Runge currently serves as Administrator of the National Highway Traffic Safety Administration (NHTSA) at the Department of Transportation. Secretary Chertoff issued the following statement:

?I am pleased that Dr. Runge will join our team as the Department of Homeland Security?s first Chief Medical Officer,? said Secretary Chertoff. ?Dr. Runge is an extraordinary physician and public servant. He and his team will have primary responsibility for working with HHS, Agriculture and other departments in completing comprehensive plans for executing our responsibilities to prevent and mitigate biologically-based attacks on human health or on our food supply.?

…The new Chief Medical Officer will provide the federal government with a much greater capacity to be prepared for, respond and recover from a catastrophic attack. The Chief Medical Officer was announced yesterday as part of the Secretary?s second stage review and will reside in a newly proposed Preparedness Directorate that will focus on ensuring the Secretary?s resources are targeted towards the greatest risk.

Prior to serving as Administrator of NHTSA, Dr. Runge practiced and taught emergency medicine as Assistant Chairman of the Department of Emergency Medicine at Carolinas Medical Center in Charlotte. Dr. Runge has also served as Director of the Carolinas Center for Injury Prevention and Control. He is board-certified in Emergency Medicine and has served in leadership positions in various local, regional and National organizations including the American College of Emergency Physicians and the Association for the Advancement of Automotive Medicine. He earned his Bachelor?s degree from the University of the South in Tennessee and his Doctor of Medicine from the University of South Carolina.

Here’s the DHS wire diagram though the new Preparedness office doesn’t show up in here (yet). Best of luck to Dr. Runge!

A Texas federal judge has issued a blistering 249-page order and sanctioned a high-profile plaintiffs law firm, accusing the plaintiffs bar of manufacturing a "phantom epidemic" of the lung disease silicosis.

And at least one legal expert suggests a similar finding might come if courts look closely at recent absestosis litigation.

…"Despite diagnosing a serious and completely preventable disease at unprecedented rates, not a single doctor even bothered to lift a telephone and notify any governmental agency, union, employer, hospital or even media outlet, all of whom conceivably could have taken steps to ensure recognition of currently undiagnosed silicosis cases and to prevent future cases from developing," [Federal Judge] Jack wrote.

Jack suggested the reason for the discrepancy was that "these diagnoses were about litigation rather than health care."

Don’t go crazy, a lot of the cases cited here were just sent back to state courts, but I think this is a good sign.

"…Once the shock had settled, I started to feel immense pride that the LAS, the other emergency services, the hospitals, and all the other support groups and organisations were all doing such an excellent job. To my eyes it seemed that the Major Incident planning was going smoothly, turning chaos into order."

We’re going to have to have a MedBlogger Conference, if only to settle the numbering nomenclature for Grand Rounds. Just like a bunch of docs to have stubborn opinions about the ‘right’ way to do something. Heh.

The U.S. military needed a performance nutrition bar for the toughest customer in the world – the American soldier. No bar on the market was up to the challenge. So it created the HOOAH! bar. The HOOAH! bar’s mission: to "improve the physical and mental performance of soldiers during sustained operations and under all climatic conditions."

Soldiers are using it at this very moment, in the far corners of the world.

And now it’s available for everyone. Whether you’re hiking 30 miles in the woods, battling a deadline at work, or commanding a platoon of unruly children at home, HOOAH! helps you soldier through.

From their website, it’s a bar that will make you stronger, and probably a little taller and better looking. Available at 7-11 and through Amazon.

Ever wonder what new residents think while trying to learn to be anesthesiologists? Wonder no more: the underwear drawer.

…I am having a good time on the job, though. It is true, the analogies they make about conducting anesthesia and flying a plane. It’s the takeoffs and landings that are the really scary parts (corresponding of course to inducing the patient and waking them up at the end), but the difference is that at this point, the time in flight is scary for me too. I expect at some point, it becomes more of a "we have reached our cruising altitude, you are now free to move about the cabin" kind of feeling, but at this point, it’s more like, "HOLY F****** S***, I’M FLYING A PLANE!" But it’s really very fun and extremely exciting despite it all. In the words of that irrepressible carrot-topped scamp Annie Warbucks, "I think I’m gonna like it here." …

Hehe. I’ll bet every doctor can identify, that period of "I can’t believe they’re letting ME do this…", but it’s a normal, necessary part of training.

And if Dr. Au’s blog isn’t on your daily reading list, you’re missing one of the best life-and-times medical bloggers.

For the first time in my career, I wanted to smack the SHIT out of a doctor today.

Okay, there are times when slow torture, stoning, sabotage and just plain evilness have danced in my fantasies in relation to physicians, but this was just an out and out violent impulse. If she would have been within eyesight I probably would have been fired (or jailed).

Read the rest to see what brought this on.

Unsolicited advice to the offending intern: start planning to change residencies as an R2 now. Trust me, the next 4 years, 357 days will make you wish you were dead.

This is not a serious or earthshattering post, but it’s something I’ve noticed and think it’s funny.

I use a little program called Weatherbug, which is a handy way to get local weather info, and remote weather should you desire. It has several tabs, like ‘radar’, ‘photos’, ‘traffic’, but the one I have noticed is the one that’s first, ‘camera’.

‘Camera’ is a live camera, probably selected to be the one nearest my zip code, and the same one comes up every time, from J. L. Boren Elementary School, Mansfield, TX. Why they want to keep an eye on their dumpsters, and broadcast that to the world, is beyond me. I do check in on them, from time to time, to see if they’ve moved. So far, well, they’re dumpsters.